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Quadrilateral Space Syndrome S44.30XA 955.0

Quadrilateral Space

throwing-athlete-differential-diagnosis

 

shoulder capsule anatomy

Upper extremity sensory innervation

Upper extremity nerve root innervation

Teres atrophy MRI

 

ICD-9 Classification / Treatment
Etiology / Epidemiology / Natural History Associated Injuries / Differential Diagnosis
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review Reference

synonyms: quadrilateral space syndrome

Quadrilateral Space Syndrome ICD-10

 

A- initial encounter

D- subsequent encounter

S- sequela

Quadrilateral Space Syndrome ICD-9

  • 955.0 Injury to peripheral nerve of shoulder girdle: Axillary nerve

Quadrilateral Space Syndrome Etiology / Epidemiology / Natural History

  • Compression of the Axillary nerve and posterior humeral circumflex artery as they run through the quadrilateral space.
  • Often associated with a history of trauma to the posterior shoulder.

Quadrilateral Space Syndrome Anatomy

  • Borders of Quadrilateral space: teres minor superiorly, humeral shaft laterally, teres major inferiorly, long head of triceps medially.
  • Contents of Quadrilateral space: Axillary nerve, posterior humeral circumflex artery.
  • Compression is generally from fibrotic bands in the quadrilateral space.
  • See also Shoulder Anatomy.

Quadrilateral Space Syndrome Clinical Evaluation

  • Complain of vague posterior shoulder pain just under the region of the teres minor. Pain is exacerbated in the late cocking phase in throwing athletes.
  • Symptoms exacerbated by forward flexion and/or abduction and external rotation.
  • Discrete joint tenderness posteriorly in the quadrilateral space.
  • May have paresthesia ove rhte lateral shoulder and upper posterior arm.
  • May have deltoid weakness associated with decreased shoulder abduction.

Quadrilateral Space Syndrome Xray / Diagnositc Tests

  • AP, scapular lateral and axillary views generally normal.
  • Subclavian arteriogram done by the Seldinger technique demonstrates occlusion of the posterior humeral circumfelx artery with the arm in abduction and external rotation.
  • MRI: may demonstrate teres minor atrophy / paralabral cysts.

Quadrilateral Space Syndrome Classification / Treatment

Quadrilateral Space Syndrome Associated Injuries / Differential Diagnosis

  • SLAP Lesion:
  • Posterior Capsular Contracture:
  • RTC Tear: usually partial-thickness articular sided supraspinatus tears.
  • Anterior Shoulder Instability:
  • Acromioclavicular Arthritis:
  • Distal Clavicle Osteolysis:
  • Suprascapular Neuropathy
  • Thoracic Outlet Syndrome
  • Quadrilateral Space Syndrome
  • Aneursyms: subclavian, axillary, posterior humeral circumflex arteries

Quadrilateral Space Syndrome Complications

Quadrilateral Space Syndrome Follow-up Care

Quadrilateral Space Syndrome Review References

  • Cahill B, J Hand Surg 1983;8:65
  • Lester K, Am J Orthop 1999;28:718